title: Preoperative CYFRA 21-1 and CEA as prognostic factors in patients with stage I non-small cell lung cancer.
abstract: OBJECTIVE
  This study investigated the preoperative serum levels of CYFRA 21-1 and CEA as prognostic factors in patients with stage I non-small cell lung cancer.
  
  
  METHODS
  This study evaluated 341 patients who had undergone a complete resection for stage I NSCLC between 2002 and 2008.
  
  
  RESULTS
  The patients included 193 males and 148 females. The mean age of the patients was 69.2 years (range: 19-88). The histological types included 264 adenocarcinomas, 56 squamous cell carcinomas, 11 large cell carcinomas, and 10 other types of carcinoma. A pneumonectomy was performed in 2 patients, a bilobectomy in 7, a lobectomy in 255, a segmentectomy in 46, and partial resection of the lung in 31 patients. The positive rates for CYFRA 21-1 in the adenocarcinoma and squamous cell carcinoma patients were 33.3% and 76.8%, respectively. The positive rates for CEA in adenocarcinoma and squamous cell carcinoma patients were 23.8% and 26.8%, respectively. The 5-year survival rate after surgery in the normal CYFRA 21-1 group and the high CYFRA 21-1 groups were 92.8% and 75.4%, respectively, in the patients with stage I NSCLC. There was a significant difference between the 2 groups (p<0.0001). The 5-year survival rate according to the serum level of CEA in the patients with stage I NSCLC were 88.3% for the normal group and 76.3% for the high group. In a multivariate analysis using the variables found to be significant prognostic factors in univariate analysis, a high CYFRA 21-1 level was found to be a significant independent prognostic factor (95% confidence interval 1.213-5.442, p=0.014).
  
  
  CONCLUSIONS
  A high preoperative CYFRA 21-1 level was a significant independent prognostic factor in patients with stage I NSCLC. The patients with a high CYFRA 21-1 level should carefully followed-up to rule out occult metastasis. Further clinical studies will be necessary to evaluate the efficacy of adjuvant therapy for the patients selected according to this criterion.
authors.affiliation: Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu 807, Japan. hanagiri@med.uoeh-u.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hanagiri
authors.forename: Masakazu
authors.initials: M
authors.lastname: Sugaya
authors.forename: Masaru
authors.initials: M
authors.lastname: Takenaka
authors.forename: Sohich
authors.initials: S
authors.lastname: Oka
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Baba
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: Yoshika
authors.initials: Y
authors.lastname: Nagata
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Shimokawa
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Uramoto
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takenoyama
authors.forename: Kosei
authors.initials: K
authors.lastname: Yasumoto
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000235:genetics / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000235:genetics / Q000378:metabolism*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000235:genetics / Q000378:metabolism*; D016019:Survival Analysis
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; D011956:Receptors, Cell Surface; C102012:antigen CYFRA21.1; C065686:carcinoembryonic antigen binding protein, human